The incidence of appendicitis is about 1:1000-1:1500 pregnancies. Therefore, it seems to be in pregnancy as frequent as in the general population. The common signs and symptoms of appendicitis are in pregnancy less reliable than in nonpregnant women. An important role to diagnose appendicitis in suspicious cases has the ultrasonography, first of all the "graded compression ultrasound". Appendicitis increases the rate of spontaneous abortions, preterm delivery, small for gestation babies, and neonatal mortality in the first 7 days of life. After appendectomy the rate for preterm deliveries is increased for seven days. After the 7th postoperative day the pregnancy usually continuous to term. There is no increase of malformations because of appendectomy. At the end of pregnancy appendicitis is frequently complicated by phlegmoneous and perforated forms of illness with and without peritonitis. Before 20th w.o.p. laparoscopy is a recommendable method to diagnose and treat appendicitis. After 20th week of pregnancy laparotomy should be preferred. Cesarean section is not recognized part of treatment for appendectomy and only to be performed for obstetric reasons. Tocolysis should be prevented because of risk of pulmonary injury.